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Insertive Oral Statistics
Apr 23, 2009

Hi Dr. Bob, First let me say how much I admire your spirit, in dealing with a deadly viru as well as educating common people about the risks. I have a question about the risks of HIV transmission from insertive oral. The Vargehese paper from 2002 quoted by the CDC (and subsequently Wikipedia and you and more sources) states that the aquisition risk is 0.5/10,000 episodes. This is just an assumption, as even the paper states that there is no data to back up this number. From what I understand, there are no documented cases. You already know this, so why am I writing? The risk difference between insertive oral and vaginal is 10x. Someone might think that if they go for the former, then the latter is not all that more risky. Maybe you should change the nature of risk for insertive oral from 0.5/10,000 to extremely low? Just a suggestion. Anyway, my hat off to you for your efforts.

Response from Dr. Frascino

Hi,

Most HIV specialists who have been in practice for a while have seen patients who claim insertive oral sex is their only HIV-risk exposure. These are anecdotal reports. There are no "documented cases," because that would require the sex police monitoring a couples' every sexual move to assure there was absolutely no other potential risk activity. The CDC estimated-risk statistics are very conservative and serve as an educational tool to show people the relative risk associated with various sexual practices. In that light, if vaginal sex is 10 times more risky than oral sex, it should make people think twice about taking that risk. The trouble with words like "low" is that no one really knows what that means. Our basic message should remain: Anal sex is more risky than vaginal sex which in turn is more risky than oral sex. The receptive partner is always at greater risk than the insertive partner for all types of penetrative sex. Use a latex or polyurethane condom for penetrative sex!

Dr. Bob



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